The first thing that pops into everybody’s mind when they hear a patient state they have chest pain radiating to the left arm is Acute Coronary Syndrome and specifically a Myocardial Infarction. However, there are a lot of orthopedic causes of chest pain that can also radiate to the left arm. It is estimate that up to 20% of patients with pectoral symptoms have an underlying orthopedic problem.
Some of them are:
Herniated Disc
Cervicothoracic tension syndrome
Blockage of intervertebral or rib joints
intercostal neuralgia
Some other less common causes are
Arthritis of the shoulder
Spondylocystitis
Osteoporotic fractures
Bone tumors
So instead of just ordering some troponin and admitting to medicine, consider that the cause can be orthopedic in origin.
References
Fromm B. Often an orthopedic problem can manifest as chest pain. Cervical vertebrae syndrome mimics myocardial infarct. MMW Fortschr Med 2002 Apr 25; 144(17):31-3.
